Dry Eye

How do we determine if you are suffering from dry eye?

In our Dry Eye Clinic we will conduct a series of evaluations and determine the likely cause of your Dry Eye symptoms.

First, you will complete a Dry Eye lifestyle questionnaire – this brief assessment allows us to understand how your eyes feel on a daily basis. (Feel free to print out our online copy, complete the questionnaire, and bring it to your next appointment.)

If the questionnaire indicates symptoms beyond mild, we will proceed with several tests to determine what the cause of ocular irritation or Dry Eye may be.

After evaluation, your doctor will be able to determine the best options for you. One of the treatments offered at Advanced Vision Care is a prescription eyedrop to help address the underlying cause often related to inflammation. Treatment options may include Restasis, Xiidra, or autologous serum tears.

Our very own Dr. Shamie is the national spokesperson for Restasis. Over 5 years ago, she experienced dry eye symptoms and began using Restasis. The doctors at Advanced Vision Care believe strongly in offering targeted treatment to treat the underlying cause and prevent worsening of the largely ignored problem of chronic dry eyes. Through their experience and extensive knowledge of dry eyes, the doctors at Advanced Vision Care have helped thousands of patients reduce the symptoms and discomfort of dry eye disease.

Several different instruments are used to evaluate for Dry Eye.  Among some of these are LipiView®, TearLab® Osmolarity testing, Schirmer testing, InflammaDry®, Meibography, and various other techniques.

 

LipiView®

LipiView® takes extremely detailed images of your eye's tear film. 

The procedure is non-invasive, can be performed in our office, and takes less than five minutes. If you've ever had a comprehensive eye exam, LipiView® will feel similar. The tear film can be clearly seen as an array of colors that are reflected when a light source is directed towards the front surface of the eye. Readings are instantly calculated and displayed on the LipiView® monitor.  LipiView® also creates an elegant video which allows the doctor to asses blinking habits.

 

TearLab® Osmolarity

TearLab® Osmolarity essentially looks at the content of the tears made from the eye.  Are your tears more salty than watery?  This instrument will aid in diagnosis.

 

Dry Eye is treated in many different ways.  In our clinic, patients will be treated based on their severity.  Some of our unique treatments include:

  • ocular and/or oral medications from OTC Artificial Tears to compounded Serum Tears,
  • tailored lid hygiene management,
  • amniotic biotissue for severely damaged corneas,
  • scleral contact lenses which change the ocular surface environment,
  • and other treatments such as LipiFlow®.

Dry Eye Diagram

 

Serum Tears serve not only as a lacrimal tear substitute to provide lubrication, but also contain other biochemical components (i.e. proteins, antibodies) mimicking natural tears more closely.

 

Our natural tears are made up of key components not found in artificial tear products, such as epidermal growth factor (EGF), fibronectin and vitamin A, which support the proliferation, maturation, migration and differentiation of corneal and conjunctival epithelia.  We also know that serum contains IgG, lysozymes and complement, which have bacteriostatic properties. If these factors are low or missing, there is increased risk of persistent epithelial defects, blurred vision, infection and scarring.

 

Studies have shown that Serum Tears improve both patient symptoms and ocular surface especially in patients with diseases such as Sjögren’s Syndrome.

 

ProKera® and Ambiodisk®

ProKera® and Ambiodisk® are revolutionary biotissues made of amniotic tissue which is used to help protect, heal, and repair damaged corneal tissue.  This tissue may be needed in cases of severe Dry Eye.

 

Scleral Contact Lenses are custom designed and fabricated prosthetic devices to replace or support impaired ocular surface system functions.  These rigid lenses are about the size of a nickel and are made of gas-permeable plastic.  They function to create:

  • A new transparent, smooth optical surface over the irregular, damaged or diseased cornea
  • An expanded artificial tear reservoir that provides constant lubrication while maintaining necessary oxygen supply.

LipiFlow®

LipiFlow®, the groundbreaking treatment, addresses the root cause of Evaporative Dry Eye 

 

If you've been unable to receive long-lasting relief from the over-the-counter or prescription remedies you've tried, it may be because they haven't been targeting the primary cause of your condition – the blockage of your Meibomian glands located in your eyelids. Perhaps you've tried things like eye drops and warm compresses, which many find inconvenient and only offer short-term relief.

The LipiFlow® Thermal Pulsation System, by TearScience®, is a significant technological shift managing evaporative dry eye. With a single procedure, applying a combination of directed heat and pulsatile pressure, many find a single treatment effective in relieving the blockage of their Meibomian glands. The LipiFlow® System is intended for the application of localized heat and pressure therapy in adult patients with evaporative dry eye. Opening the blocked glands may allow your body to resume its natural production of tear film oil.

 

LipiFlow® treatment is clinically proven with sustained results. In a clinical study about 79% of patients reported an improvement in overall dry eye symptoms after a single LipiFlow® treatment. Depending on the severity of your specific condition and your response to treatment, you may need to repeat the LipiFlow® treatment periodically as your symptoms return over time.

With LipiFlow® – and regular checks and ongoing care to monitor your progress – let us help you experience Dry Eye relief like never before.

 

What actually happens during a LipiFlow® treatment?

The LipiFlow® Activator (a disposable eyepiece) is inserted under your lower and upper eye lid and is shaped to prevent contact with your cornea. Once in place, you simply recline in the treatment chair and experience the 12 minute procedure. In a clinical study, 32% of patients reported no discomfort and 48% of patients noted awareness of pressure without pain during the LipiFlow treatment. The average total Meibomian gland score for patients who received a single LipiFlow treatment more than doubled from 6.3 ± 3.5 glands at the baseline to 16.7 ± 8.7 glands at 4 weeks. As previously mentioned, 79% of patients treated with LipiFlow in the clinical study reported an improvement in overall dry eye symptoms.

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